Healthcare Provider Details

I. General information

NPI: 1114935046
Provider Name (Legal Business Name): DR AARON DAVID AND DR HERMAN WEISS OB GYN PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

980 BROADWAY
MASSAPEQUA NY
11758
US

IV. Provider business mailing address

980 BROADWAY
MASSAPEQUA NY
11758
US

V. Phone/Fax

Practice location:
  • Phone: 516-795-2890
  • Fax: 516-795-7450
Mailing address:
  • Phone: 516-795-2890
  • Fax: 516-795-7450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number149064
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number215938
License Number StateNY

VIII. Authorized Official

Name: AARON DAVID
Title or Position: DOCTOR
Credential: DO
Phone: 516-795-2890